Provider Demographics
NPI:1083042634
Name:CY-FAIR PAIN INTERVENTION
Entity Type:Organization
Organization Name:CY-FAIR PAIN INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-320-4920
Mailing Address - Street 1:11585 FM 1960 RD W
Mailing Address - Street 2:STE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3607
Mailing Address - Country:US
Mailing Address - Phone:832-686-7656
Mailing Address - Fax:281-955-0053
Practice Address - Street 1:11585 FM 1960 RD W
Practice Address - Street 2:STE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3607
Practice Address - Country:US
Practice Address - Phone:832-686-7656
Practice Address - Fax:281-955-0053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3719207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty